Homestead_Moore (6) RUSK FORM 535 IR:r uPl TREASURER FORA(11A
�PPREWED STATUE 0111110 OF Arty sts 2U PREYNUFOBY mC DEPART 4E T(W LOCAL COVEPPIrw'T FINANCE M VLI-114.1
101 Nr Courty Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sandant deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than escr for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HEA 1344-2000 requires taxpayers who receive the homestead standard deduction to serifs that they are eligible to teoeise the
benefit and to provide additional identifying information necessity to allow county government to better manta homestead
tiliap.This inhumation will he kepi confidential and can only he acce■ed by:uthori,ed county officials.The Department of
Laval Government Finance will use this infomoation to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Moore, Stephen E/Vicki L
502 li Poplar
Fon Branch IN 47648
7847
Stephen E/Vicki L Moore
502 E Poplar State Parcel Number Leval Description
Fort Branch IN 47648-1744
26-19-19-101-000.529-026 011-00529-00 CLAR-ENCE TERRACE B 20
nnlIt111111l
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
-Ong �egg" ooh
Address(mum and inm,city,state,and ZIP code - — — - --ErSame as property address - — — —
• 10/Olar- `f code
oo- 21c CiLaG Cl
_�
Spouse First Middle Last
Mailing Address(Number and street,city.state,and ZIP code) -Same as property address
.Soo Ag(a 4 ff &Vc-C. - f (17C5-c
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury',that the above and foregoing information is true and correct and that he or she is eligible to
receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature Date
•
•
wun xc ia iem
PreunDetl By State Baara af 7ax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOfl YEAR 19 °!�I
To & FileG in Oupliwte
SEE BACK FOR FILING INSTRUCTIONS �/ Da/�� Q 4�
J J�.
�(We) ���� �-� �- `�����- � certify that on the 1st day of
.arch, 19� I, (We) occupie as our principal place of residence the following described real property for
which a �H�o/�mesteadt Property/ Tax Cnredit is hereby bein�/g cla,i'metd: �� /�
`� OC�ri R.OIMLnfLNQ.°f.�. 4lan �/-n([fl E�<d. /iL��-K� �-�'C_
I, (We) � owne� .
❑ are buying under contract
❑ have a beneficial intere/s�t in-the taxpayer �7�
Property Description in ��-�+ County 1�1�+-�*�^ Township
Taxing District (Giiy-Town, Tnucuskrip): ��' !��'s�
Parcel Number or legal description shown on tax statement:
� ce�� �?�,<.,�� � Z �
If buying on contract: Owners name ��� simo�e owner�
Contract recorded in Recorders Office - Record No. Page
If any portion of the reSidential structure or the land, not exceeding one (1) acre that immediately surrounds that
structure is used to produce income,'describe the use and portion of the property utilized to produce income
Any other counties in which individual owns or is buying real property:
certify the above statement is true, correct and complete.
Stteet Aaaress
County Township
��«��_ �� y
Ciry. State entl Zi0 �e
Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one) acre immediately
surrounding residentia� �v�nt� �
Other Land
Total Lantl ��
Residential Improvements �U� �Ji? ig�g Dwelling
��
Other Improvements ��
r/� Garage
/ L�4� Total
AUDITOR
To' ' Improvements - Line (6) plus (7) equals (8)
I�y certify the above is true. correct. and complete.
Signa:ure of
Approved
True Cash
Value
(�) � `�O
(2)
(3) G% `��
(4) ��-o
(5) a � 3 � o
(6) / ��-�°' ' °
(�) —
(g� /�f—�o
- ACTION BY AUDITOR -
Assessed
Valuation
�/o
/O
Homestead
Valuation
�/o
TJ...�-� �, ��-�
�'`�--3-fo-
S��- f��9
Date
Date: